Melatonin and organ transplantation: what is the relationship?

OBJECTIVE: Melatonin has anti-inflammatory and antioxidant properties that can influence tissue growth and apoptosis. This aspect may influence the success of organ transplantation. To evaluate the relationship between melatonin and organ transplantation. METHODS: A systematic review was performed in PubMed databases using the search terms: "melatonin physiology" or "melatonin therapy" and "transplant pharmacology" or "transplant physiology" or "transplant therapy" or "Transplant therapy". Experiments on the organs of the reproductive system were not included. After analysis, five articles were selected after reading the title and abstract of 50 manuscripts. The works were divided into two aspects: a) analysis of the influence of the organ transplantation procedure on melatonin production; b) action of melatonin on organ transplantation. RESULTS: The cardiac transplantation surgical procedure, immunosuppression, and graft did not influence melatonin secretion in rodents, but there was a significant reduction of melatonin in the renal transplantation procedure in patients with renal insufficiency. Melatonin administration in experimental models decreased rejection and improved transplant success. CONCLUSION: Studies show that melatonin can reduce organ and species dependence, and the use of melatonin decreases graft rejection.

Melatonin and organ transplantation: what is the relationship?

SUMMARY Melatonin has anti-inflammatory and antioxidant properties that can influence tissue growth and apoptosis. This aspect may influence the success of organ transplantation. OBJECTIVE To evaluate the relationship between melatonin and organ transplantation. METHODS A systematic review was performed in PubMed databases using the search terms: "melatonin physiology" or "melatonin therapy" and "transplant pharmacology" or "transplant physiology" or "transplant therapy" or "Transplant therapy". Experiments on the organs of the reproductive system were not included. After analysis, five articles were selected after reading the title and abstract of 50 manuscripts. The works were divided into two aspects: a) analysis of the influence of the organ transplantation procedure on melatonin production; b) action of melatonin on organ transplantation. RESULTS The cardiac transplantation surgical procedure, immunosuppression, and graft did not influence melatonin secretion in rodents, but there was a significant reduction of melatonin in the renal transplantation procedure in patients with renal insufficiency. Melatonin administration in experimental models decreased rejection and improved transplant success. CONCLUSION Studies show that melatonin can reduce organ and species dependence, and the use of melatonin decreases graft rejection.

RESUMO A melatonina tem propriedades anti-inflamatórias e antioxidantes que podem influenciar o crescimento e a apoptose dos tecidos. Esse aspecto pode influenciar o sucesso do transplante de órgãos. OBJETIVO Avaliar a relação entre a melatonina e o transplante de órgãos. MÉTODO A revisão sistemática foi realizada nas bases de dados do PubMed, usando os termos de pesquisa: "fisiologia da melatonina" ou "terapêutica da melatonina" e "farmacologia do transplante" ou "fisiologia do transplante" ou "terapêutica do transplante" ou "terapia do transplante". Não foram incluídos os experimentos sobre os órgãos do sistema reprodutivo. Após análise, cinco artigos foram selecionados após a leitura do título e do resumo de 50 manuscritos. Os trabalhos foram divididos em duas vertentes: a) análise da influência do procedimento de transplante de órgão na produção de melatonina; b) ação da melatonina sobre o transplante de órgãos. RESULTADOS O procedimento cirúrgico do transplante cardíaco, a imunossupressão e o enxerto não influenciaram a secreção de melatonina em roedores, mas houve redução significante da melatonina nos casos do procedimento de transplante renal em pacientes com insuficiência renal. A ministração de melatonina em modelos experimentais diminuiu a rejeição e melhorou o sucesso de transplante. CONCLUSÃO Os estudos mostram que a melatonina pode reduzir a dependência da espécie e do órgão e que o emprego da melatonina diminui a rejeição do órgão.

Immune manifestations with checkpoint inhibitors in a single Brazilian center: experience and literature review.

OBJECTIVES: The presence of autoimmune events were recorded in patients receiving immune checkpoint inhibitors. MATERIALS & METHODS: Retrospective study in patients receiving immune checkpoint inhibitors (ICIs) during the period of 2012-2019. RESULTS: A total of 554 patients received ICIs of which 123 developed an immune related adverse event. Twenty one (17%) with toxicity were identified as having a pre-existing autoimmune disease and 88 required treatment with corticosteroids or hormone replacement. Thirty two (26%) out of 123 had to temporarily discontinue ICIs due to autoimmune manifestations. Endocrine and skin manifestations were the most prevalent immune disorders in our cohort. In melanoma better efficacy was seen in patients with immune toxicity. CONCLUSION: Autoimmune diseases appear in patients receiving ICIs in this real world experience. Our results differ from other series on the frequency of autoimmunity. Complete discontinuation of ICIs due to autoimmunity was rare.

Analysis of the Abscopal Effect With Anti-PD1 Therapy in Patients With Metastatic Solid Tumors.

Abscopal effect is a rare phenomenon characterized by tumor regression of untreated metastatic lesions after a local therapy (eg, radiotherapy). We studied the probability of abscopal effect with radiotherapy associated with anti-programmed death cell 1 (PD1) therapy after progression on anti-PD1. This study is a retrospective analysis of patients treated with nivolumab or pembrolizumab for melanoma, non-small cell lung cancer (NSCLC) and renal cancer at Antônio Ermírio de Moraes Oncology Center, Brazil. To be eligible for this analysis, patients must have had unequivocal evidence of disease progression on anti-PD1 therapy and subsequent radiotherapy for any tumor site while still receiving anti-PD1. The abscopal effect was characterized as a response outside the irradiated field after radiotherapy plus anti-PD1. Sixteen patients were evaluated, including 12 metastatic melanoma, 2 metastatic NSCLC, and 2 metastatic renal cell carcinoma. The median time to disease progression on anti-PD1 was 3 months. The radiotherapy field included lung, lymph nodes, and bones, with a median total dose of 24 Gy (1-40 Gy), usually in 3 fractions (1-10 fractions). Three patients with melanoma developed an abscopal effect at a rate of 18.7% (25% among melanoma patients). Of note, one of them achieved a remarkable complete response lasting >6 months. Three patients with melanoma obtained a significant local response after radiotherapy, despite no response in distant metastases. Eleven patients presented disease progression after radiotherapy. No increased toxicity was observed. In conclusion, no patients with NSCLC or renal cancer showed abscopal effect, but 25% of patients with melanoma showed regression of nonirradiated lesions when anti-PD1 was continued after radiation to a tumor site that had progressed on anti-PD1 monotherapy.

Evaluation of results obtained with corifollitropin alfa after poor ovarian response in previous cycle using recombinant follicular stimulating hormone in the long-term protocol.

OBJECTIVE: This study evaluated the use of Corifollitropin alfa in patients with previous poor response to recombinant follicle stimulating hormone in long-term protocols using gonadotropin-releasing hormone. METHODS: Twenty-seven poor responders to previous treatment with the long term protocol using the recombinant follicle stimulating hormone (Group 1) were selected and then submitted to a second attempt using the same long term protocol with Corifollitropin alfa instead of the recombinant follicle stimulating hormone (Group 2).Ovarian down-regulation was achieved using subcutaneous administration of Leuprolide Acetate. Ovarian stimulation was performed with recombinant follicle stimulating hormone until the administration of human chorionic gonadotropin, followed by follicular aspiration (Group 1). Group 2 was submitted to this same protocol using Corifollitropin alfa instead of recombinant follicle stimulating hormone. RESULTS: There were significant differences in the number of aspirated oocytes, percentage of mature oocytes, amount of injected oocytes and transferred embryos - with all of these parameters being increased in the Corifollitropin alfa group. In addition, the rates of pregnancy and ongoing pregnancy were also significantly higher in the Corifollitropin alfa group. CONCLUSION: The present study demonstrated that the use of Corifollitropin alfa in the long-term protocol could be a highly effective alternative for patients with poor ovarian response, who were unsuccessful in a previous treatment with In Vitro Fertilization - Intracytoplasmic Sperm Injection.

Síndrome Wei em pequenos animais / Wei Syndrome in small animals

A preocupação cada vez mais crescente dos proprietários com seus animais de companhia vêm fazendo com que busquem novas alternativas para que se complemente o tratamento ou controle das doenças crônicas, debilitantes e/ou degenerativas em seus animais. Dessa forma, a acupuntura tem contribuído para a diminuição e até muitas vezes para a remissão do conjunto de sinais clínicos que levam à disfunção e atrofia dos músculos, conhecida como Síndrome Wei na Medicina Tradicional Chinesa, e que na Medicina Ocidental é observada em diversas doenças, dentre elas botulismo, miastenia gravis, polirradiculoneurite e cinomose (seqüelas). Este trabalho tem por objetivo descrever a Síndrome Wei, bem como as duas principais formas de tratamento – acupuntura e fitoterapia chinesa – usadas na Medicina Chinesa

The growing concern of the owners with their pest resulting in the searching of new alternatives to complement the treatment and the controlol of the weakeningly and/or degenerative chronic pathologies in pets. Thus, the acupuncture has been contributing to decrease and even for elimination of the group of clinical symptoms resulting in dysfunction and atrophies of the muscles – known as Wei Syndrome in the Chinese Traditional Medicine. In the Western Medicine it is observed in a wide group of pathologies, among them the botulism, miastenia gravis, polyradiculoneuritis and dog distemper (sequels). This work has the objective of describing the Wei Syndrome, as well as the two main treatment types – acupuncture and Chinese phytotheraphy – both used in the Chinese Medicine

Síndrome Wei em pequenos animais / Wei Syndrome in small animals

A preocupação cada vez mais crescente dos proprietários com seus animais de companhia vêm fazendo com que busquem novas alternativas para que se complemente o tratamento ou controle das doenças crônicas, debilitantes e/ou degenerativas em seus animais. Dessa forma, a acupuntura tem contribuído para a diminuição e até muitas vezes para a remissão do conjunto de sinais clínicos que levam à disfunção e atrofia dos músculos, conhecida como Síndrome Wei na Medicina Tradicional Chinesa, e que na Medicina Ocidental é observada em diversas doenças, dentre elas botulismo, miastenia gravis, polirradiculoneurite e cinomose (seqüelas). Este trabalho tem por objetivo descrever a Síndrome Wei, bem como as duas principais formas de tratamento acupuntura e fitoterapia chinesa usadas na Medicina Chinesa(AU)

The growing concern of the owners with their pest resulting in the searching of new alternatives to complement the treatment and the controlol of the weakeningly and/or degenerative chronic pathologies in pets. Thus, the acupuncture has been contributing to decrease and even for elimination of the group of clinical symptoms resulting in dysfunction and atrophies of the muscles known as Wei Syndrome in the Chinese Traditional Medicine. In the Western Medicine it is observed in a wide group of pathologies, among them the botulism, miastenia gravis, polyradiculoneuritis and dog distemper (sequels). This work has the objective of describing the Wei Syndrome, as well as the two main treatment types acupuncture and Chinese phytotheraphy both used in the Chinese Medicine(AU)